Dataset Information

Asymptomatic coronary heart disease in patients with type 2 diabetes with vascular complications: a cross-sectional study.

ABSTRACT:

Background

Recent studies have suggested that microvascular and macrovascular diseases are associated with coronary events.

Objective

To test the hypothesis that asymptomatic coronary heart disease (CHD) may be present in many patients with diabetes with vascular complications.

Design

From April 2009 to August 2010, the authors conducted a cross-sectional study to assess the prevalence of asymptomatic CHD among patients with type 2 diabetes with vascular complications at a national diabetes centre in Japan. Eligibility criteria included patients with type 2 diabetes with no known CHD and one or more of the following four criteria: (1) proliferative diabetic retinopathy or after photocoagulation; (2) estimated glomerular filtration rate <30 ml/min/1.73 m² or an estimated glomerular filtration rate <45 ml/min/1.73 m² plus albuminuria; (3) peripheral arterial disease; and (4) cerebrovascular disease. Each patient underwent a stress single-photon emission computed tomography; patients with myocardial perfusion abnormalities then underwent coronary angiography.

Results

A total of 1008 patients with type 2 diabetes were screened, and 122 eligible patients consented to participate. Stress single-photon emission computed tomography revealed myocardial perfusion abnormalities in 96 (79%) patients. Of the 112 patients who completed the study protocol, 59 (53%) had asymptomatic CHD with ?50% diameter stenosis. Additionally, 35 (31%) patients had multivessel disease or left main disease, and 42 (38%) had a coronary artery with ?75% diameter stenosis. In the multivariate logistic-regression analysis to identify coronary risk factors associated with asymptomatic CHD, the only significant predictor was male sex (OR 6.18; 95% CI 2.30 to 16.64; p<0.001).

Conclusions

Asymptomatic CHD with ?50% diameter stenosis and myocardial perfusion abnormalities was detected in more than half of the patients with type 2 diabetes with vascular complications.

SUBMITTER: Tsujimoto T

PROVIDER: S-EPMC3211053 | biostudies-literature | 2011 Jan

REPOSITORIES: biostudies-literature

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Publications

Asymptomatic coronary heart disease in patients with type 2 diabetes with vascular complications: a cross-sectional study.

Tsujimoto Tetsuro T Kajio Hiroshi H Takahashi Yoshihiko Y Kishimoto Miyako M Noto Hiroshi H Yamamoto-Honda Ritsuko R Kamimura Munehiro M Morooka Miyako M Kubota Kazuo K Shimbo Takuro T Hiroe Michiaki M Noda Mitsuhiko M

BMJ open 20110101 2

<h4>Background</h4>Recent studies have suggested that microvascular and macrovascular diseases are associated with coronary events.<h4>Objective</h4>To test the hypothesis that asymptomatic coronary heart disease (CHD) may be present in many patients with diabetes with vascular complications.<h4>Design</h4>From April 2009 to August 2010, the authors conducted a cross-sectional study to assess the prevalence of asymptomatic CHD among patients with type 2 diabetes with vascular complications at a ...[more]

PMID: 22021872

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Project description:BackgroundIt is frequently observed that patients with first-ever acute ischemic stroke (AIS) have a common occurrence of asymptomatic coronary artery disease (CAD). This condition is associated with a poor prognosis. Early detection and recognition of asymptomatic CAD in first-ever AIS patients may optimize the clinical management and ultimately lead to improved outcomes. The aim of this study was to investigate the role of aortic arch plaque (AAP) detected through combined computed tomography angiography (CTA) as an early predictor of asymptomatic CAD in patients with first-ever AIS without prior diagnosis of CAD.MethodsA cross-sectional study was conducted at Xuanwu Hospital, Capital Medical University from January 2019 to December 2021, involving patients with first-ever AIS caused by large arterial atherosclerosis. Patients with a history of recognized cardiovascular disease, nonatherosclerotic arterial stenosis, atrial fibrillation related to cardioembolism, and complete carotid occlusions were excluded. The study utilized a combined coronary and cervicocephalic CTA to evaluate atherosclerosis in the cervicocephalic, aortic, and coronary arteries simultaneously. First-ever AIS patients without prior diagnosis of CAD were divided into 2 groups: 1 with asymptomatic CAD detected through CTA and the other without. Multivariate logistic regression was used to identify independent risk factors associated with the presence of asymptomatic CAD, including aortic arch, cervical and intracranial atherosclerotic characteristics (e.g., vascular stenosis, plaque thickness, extent, and complexity).ResultsAmong 182 AIS patients, 84 (46.2%) had asymptomatic CAD. Increased aortic arch plaque (AAP) thickness per millimeter [adjusted odds ratio (aOR): 1.26; 95% confidence interval (CI): 1.08-1.47], presence of severe AAP (aOR: 4.24; 95% CI: 1.59-12.03), mixed AAP (aOR: 2.65; 95% CI: 1.09-6.62), and ulcerative AAP (aOR: 11.76; 95% CI: 2.05-222.84) raised the risk of asymptomatic CAD in stroke patients, independent of other factors. The combination of ulcerative AAP, diabetes mellitus, and smoking could predict asymptomatic CAD with an area under the receiver operating characteristic curve (AUC) of 0.71 (95% CI: 0.64-0.79; P<0.001). Ulcerative AAP was found to be more valuable than cervicocephalic atherosclerotic characteristics for predicting asymptomatic CAD in first-ever AIS patients.ConclusionsThe presence of ulcerative AAP was associated with asymptomatic CAD in first-ever AIS patients. As an early systemic atherosclerosis feature, ulcerative AAP is probably a more valuable indicator than cervicocephalic atherosclerotic characteristics for predicting asymptomatic CAD in AIS patients.

Dataset Information

Asymptomatic coronary heart disease in patients with type 2 diabetes with vascular complications: a cross-sectional study.

Background

Objective

Design

Results

Conclusions

Publications

Asymptomatic coronary heart disease in patients with type 2 diabetes with vascular complications: a cross-sectional study.

Similar Datasets

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